Lexapro (Escitalopram) vs Zoloft (Sertraline)

Zoloft vs Lexapro: The Battle of The SSRIs

Anxiety and depression can be anything from a nuisance to a life altering problem. Most symptoms can disrupt relationships, work, and one’s ability to accomplish daily tasks. Talk therapy can help, but it is often only one part of the solution. If you find yourself needing extra help to get through the ups and downs, SSRIs could be right for you.

What is a SSRI?

SSRI stands for “selective serotonin reuptake inhibitor.” Say it with me now-  Selective! Serotonin! Reuptake! Inhibitors! SSRIs! Basically what this means is that any drugs in this category increase and regulate the amount of serotonin in your brain. While experts are not entirely sure HOW they do this, they are sure that it works, and that this chemical balancing act can be a huge help for those suffering from anxiety and depression, along with other nervous disorders. Not every SSRI is the same though. Each one offers different benefits and has different drawbacks.

Let's take a minute and look at two popular options side by side- Zoloft (Sertraline) and Lexapro (Escitalopram).

Meet Zoloft.

Zoloft can be prescribed to patients suffering from anxiety, depression, panic disorder, obsessive compulsive disorder (OCD), premenstrual dysphoric disorder (PMDD), and post traumatic stress disorder (PTSD). Zoloft is for adults ages 18 and older, and for many, it helps to improve how your brain communicates with the rest of your nervous system. Zoloft can help you have healthy reactions to outside stimuli. Zoloft comes in pill form and is taken orally once a day. Depending on whether you find Zoloft gives you increased or decreased energy, you may need to adjust what time of day you take it.

When starting on Zoloft, your doctor will initially give you a smaller dose, giving you body a chance to adjust gradually, and also to monitor how you react. For many a small dose does the trick, and as with any drug it is best to take less if it is already working, but for many you will gradually increase your dosage until you find one that works. In most cases, to be truly effective, Zoloft will need to build up in your body, so do not expect an instant change the first day you take it. While you are getting used to your Zoloft dosage, you may experience some short term side effects like increased anxiety and restlessness, or suicidal thoughts, which sounds like the opposite of what you would want, but it usually does not last long, and most doctors will prescribe a supplemental short term drug to help manage those extra jitters.

In the long term, Zoloft can sometimes cause changes in energy levels, changes in appetite and weight, decreased sex drive, problems sleeping, or digestive issues. There are more dangerous side effects to look out for. If you have mood or behavior changes, increased anxiety and/or panic attacks, insomnia, or if you start to feel abnormally impulsive, irritable, aggressive, restless or hyperactive, more depressed than where you started, or have thoughts about suicide or hurting yourself, it is important to call a doctor right away.
 

You should also call your doctor if you have a seizure, drastic changes in serotonin which can cause agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting, headache, confusion, slurred speech, or severe weakness, or if you have a manic episode.

Meet Lexapro.

Lexapro is prescribed to patients with anxiety and/or major depressive disorder. Unlike Zoloft, Lexapro can be prescribed to those over the age of 12, as opposed to 18, so it is a strong option for younger patients suffering from these disorders. Much like Zoloft, initial side effects can include increased anxiety and suicidal thoughts, but these should be temporary and can be managed with additional short term medications. Lexapro is also taken orally, but comes in a liquid form, which is a benefit for younger patients, or adults who are not great at swallowing pills. Lexapro needs about a month to build up in your system and become effective. Side effects can include changes in weight, decreased sex drive, insomnia, nausea and other digestive issues, vision changes, increased sweating, and lower energy levels.  You should look out for more dangerous side effect, and call a doctor immediately if you experience blurred or tunnel vision, pain in your eyes, begin to see halos around lights, racing thoughts and unusual risk-taking behavior, extreme feelings of happiness or sadness, or any of the same extreme serotonin level symptoms as with Zoloft.

What if you have tried one, did not like it, and have decided to try the other, or stop altogether?

Just like adjusting to being on medication, you should give yourself time to adjust to being off. Never stop taking SSRIs at their prescribed amount without first consulting and coming up with a plan with your doctor. Usually, doctors will have you taper off and slowly transition to a new medication, and doing it abruptly without guidance can cause a lot of misery. Switching too quickly can cause dizziness, upset stomach, abnormal mood swing, and in some cases a very uncomfortable side effect that many who experience it refer to as “brain lighting”. In addition to medications, your doctor may also recommend supplements or diet changes to help ease you off your initial SSRI without having to suffer unpleasant side effects.

As is the case with many medications, when taking SSRIs, alcohol should be avoided, as mixing the two can cause impairment dangerously fast. It is also important to note that you should not start taking or stop taking SSRIs while pregnant or breastfeeding without first speaking to your doctor. You do not want to give your baby medication they do not need, but you also do not want to risk your mental health without a solid plan that you create alongside your doctor.

With both Zoloft and Lexapro, the best approach is to be open and honest with your doctor about how effective you are finding your medication, and how disruptive the side effects are. Don’t set yourself up for failure by expecting an immediate fix. Improvement takes time and tweaking. Finding a medication that works for you, with pros that outweigh the cons, is a journey. But it is a journey that many find worth taking if they are suffering. The more you can pay attention to and track how you are feeling, the more effectively your doctor can help create a tailor made plan for your treatment.